Malaria is a debilitating disease. It triggers periodic flu-like attacks with headaches, chills and severe fevers that can last for 48 to 72 hours.

It is caused by Plasmodium parasites that are spread from human to human through bites from infected mosquitoes.

If not treated with anti-malarial drugs, the disease is often fatal. Today in Africa, malaria is responsible for one in every five childhood deaths.

Areas where malaria is endemic (there is some level of malarial infection maintained within the population) are coloured yellow. Diagram: CDC Division of Parasitic Diseases.

Plasmodium parasites use human red blood cells, which contain large quantities of haemoglobin, as food sources.

Haemoglobin is a protein used in the body for oxygen transport. If there is not enough haemoglobin (which contains iron), parts of the body will not receive adequate oxygen to keep the cells in the body producing energy.

This results in anaemia (low iron levels), causing fatigue and other symptoms.

Diagram: Based on work by National Human Genome Research Institute (US)

Interestingly, many people who live in areas where malaria is prevalent have developed resistance to the Plasmodium parasite. This appears to be linked to the genetically shaped-altered haemoglobin (sickle-like shapes, as opposed to the usual spheres).

How was malaria originally treated?

The first significant drug for malaria was quinine, a bitter-tasting white powder that comes from the bark of the cinchona tree. This tree is found in the Andes mountain ranges of Ecuador and Peru.

Quinine was introduced to Europe in the mid-seventeenth century and demand for quinine resulted in most cinchona trees being cut down.

A steady supply of quinine was re-established in the 20th century, when a chemical method of making quinine from coal tar was introduced.

The Cl (Chlorine) and Fe (Iron) parts of chloroquine and ferroquine are thought to be used to get the active quinine part of the drug close enough to kill Plasmodium parasites; they are important for drug delivery.